December 11, 2018

Trends 2017: Human Metapneumovirus (hMPV)

Human Metapneumovirus Trends

Frank Magliochetti Report

Human  is a respiratory virus that can cause lower and upper respiratory tract infections, including bronchitis and pneumonia, and may even trigger asthma. Acute respiratory tract infections are the most common reason for doctor office visits, according to the American College of Physicians. Illness associated with hMPV can be severe; the virus is associated with an associated 20,000 hospitalizations of children aged 5 and younger in the United States each year. Elderly and immunocompromised individuals are at higher risk of the disease.

History of hMPV

Until just a few short years ago, the hMPV virus was different from other common respiratory viruses as PCR-based methods using virus genome-specific primers and immunological assays using virus-specific antibodies failed to identify the pathogen. It was only after the application of a molecular biology tool, known as randomly primed PCR, could researchers identify portions of the virus’s genomic sequence.frank-magliochetti-report_hmpv_metapneumovirus_

In 2001, a team of scientists headed by B.G. van den Hoogen identified hMPV in children with respiratory tract infection by using randomly primed PCR to obtain a genomic sequence of the pathogen. Based on the sequence data currently available, the human metapneumovirus seems to be a close relation of another member of the Metapneumovirus genus, the avian pneumovirus.

Since its discovery just over 16 years ago, laboratory testing has confirmed the virus in patients around the globe. Today, scientists recognize human metapneumovirus as an emerging pathogen that may have been causing respiratory tract infections for at least 60 years.

Testing and Treatment of hMPV

american_lung_association_frankmagliochettireportTesting is not yet widely available, according to the American Lung Association, but the most common method is by swabbing and testing secretions from the nose or throat. Bronchoscopy may be used to collect specimens in hospitalized patients.

There is no direct treatment for hMPV infection so treatment focuses on alleviating symptoms of fever, runny nose, cough and sore throat. The symptoms of human metapneumovirus typically last for 2 to 5 days. Management focuses on the use of over-the-counter fever and pain remedies along with decongestants.

hMPV Trends in the United States and By Region

hMPV infections typically develop during flu season in winter and early spring, according to a report published in April 2016, and typically after the onset of respiratory syncytial virus (RSV).

The Centers for Disease Control and Prevention (CDC) collects weekly laboratory PCR and antigen testing result data and cdc-frankmagliochettireporttracks trends of hMPV by region. In nationwide testing, positive results by PCR testing for the year 2016 peaked at 9 percent in the middle of February while the number of positive antigen tests peaked at 9.5 percent in March.

hMPV peaks later in the Northeast, with positive PCR test results peaking at the end of February and March and a spike in positive antigen results of 10.4 percent at the end of April 2016.

The Midwest had the highest rates of positive test results in 2015, with about 13 percent of hMPV tests returning positive results. The southern section of the United States sees its peak hMPV tests in March with a 10 percent positive antigen testing rate and 8 percent positive PCR rate. The West had high hMPV positive test rates throughout February, reaching their 2016 PCR positive test peak of 11.3 percent in the last week of February. Antigen detection tests yielded unsteady results in that region.

The CDC and other agencies will likely collect more information about hMPV trends and treatments as diagnostic tools become more available.

Source

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1539100/

https://www.acponline.org/acp-newsroom/acp-and-cdc-issue-advice-for-prescribing-antibiotics-for-acute-respiratory-tract-infections-in

http://www.medscape.com/viewarticle/861392

https://www.ncbi.nlm.nih.gov/pubmed/11385510

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/human-metapneumovirus-hmpv/diagnosing-hmpv.html?referrer=http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/human-metapneumovirus-hmpv/learn-about-hmpv.html?referrer=https://www

http://pediatrics.aappublications.org/content/early/2016/03/31/peds.2015-2927

https://www.cdc.gov/surveillance/nrevss/hmpv/index.html

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry  – .  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Smoking Statistics: Focus on the Northeast

Smoking Statistics: Northeast USA

Cigarette smoking is still the leading cause of preventable death in the United States, according to the Centers for Disease Control and Prevention (CDC), claiming more than 480,000 lives each year. Despite decades of anti-smoking campaigns, which have been largely successful at reducing the number of cigarette smoking and death rates associated with the habit, smokingstatistics-frankmagliochettireportabout 36.5 million Americans still smoke. About 1 in 5 deaths in the U.S. are associated with smoking. Smoking remains high in certain segments of the population and in certain areas of the country. Many states are trying to reduce their number of smokers by raising tax on cigarettes, and investing in tobacco cessation programs and tobacco prevention programs.
Young adults, males, people with low education levels and those living below poverty level, lesbians, gays and bisexuals, the disabled and individuals of certain races or ethnicities are more likely to smoke. About 13 percent of people aged 18 to 24 smokes and 17.7 percent of people aged 25 to 44 smoke.
Smoking Rates by Geography
The percentage of smokers has declined in the U.S. from 20.9 percent in 2005 to 15.1 percent in 2015. Current cigarette smoking was highest in the Midwest at 18.7 percent and lowest in the West at 12.4 percent. About 13.5 percent of people living in the Northeast smoke cigarettes.
A fact sheet released November 2017 by Campaign for Tobacco-Free Kids presents state-specific tobacco-related data in very different ways. It ranks states according to adult smoking rates, adult smoking ranks, pregnant smoking ranks and annual smoking deaths. The report also looks at youth smoking rates, the number of kidsfrankmagliochettireport_smokingstatistics alive who will become smokers, and the number of children alive who will eventually die from smoking in each state. Finally, the chart lists the health costs associated with smoking, per pack tax rates and ranks, state financing for tobacco cessation programs, and tobacco prevention spending.
Kentucky has the highest adult smoking rate in the country at 25.9 percent, and the state has a relatively high percentage of pregnant smokers and youth smokers. This high smoking rate may be the result of the state’s relatively low per-pack price of $4.86. Utah has the lowest adult smoking rate at 9.1; retail price for a pack of cigarettes here is $6.43.
There is relatively low tobacco use in the Northeast; much of the low tobacco use there has to do with the relatively high per-pack price and hefty tax rates on cigarettes. At 13.5 percent, Connecticut and New Jersey are tied as the third lowest adult smoking rates in the country. Connecticut has the second highest cigarette tax rate in the nation – $3.90 per pack. New Jersey also has a high cigarette tax at $2.70 per pack.
The average price for cigarettes in Massachusetts is $9.08 per pack and the state charges $3.90 per pack in tax, the fourth highest tax in the nation. The high price of cigarettes pays off, though, as the state has the sixth lowest rate of adults smoking and one of the lowest youth smoking rates in the country.
Northeastern states and other states in the nation may continue to reduce smoking rates – and death rates associated with smoking – by increasing taxes on cigarette products and investing in tobacco cessation and prevention programs.

Source:
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Top Prescription Drugs Purchases and Trends of 2016

Top Prescription Drugs Purchases and Trends of 2016

Nearly half of all Americans take at least one prescription drug each day, according to the Centers for Disease Control and Prevention (CDC), and the cost of many of the most popular and most important medications is rising.
risingprescriptioncosts_frankmagliochettiThe Price for Prescription Drugs is Rising
Each of the past three years have seen double-digit price increases, including average rises of 12.6 percent in 2014 and over 10 percent in 2015. The average price for prescription drugs has increased an average of 10 percent in the past year. Despite pushback from insurers, scrutiny from lawmakers and outcry from consumers, many pharmaceutical companies plan to increase the price of prescription drugs.
Prescription drug spending in the United States totaled about $457 billion in 2015, according to the U.S. Department of Health and Human Services (HHS), accounting for 16.7 percent of all U.S. health care spending. In the 1990s, only about 7 percent of health care spending went towards prescription drugs.
A Wall Street Journal analysis found that prices for 30 prescription drugs increased at eight times the rate of inflation, with an average price hike of 76 percent from 2010 to 2014. Retail prices for some commonly used prescription drugs increased faster than general inflation each year from 2006 to 2013, according to AARP, which translates into an annual cost of therapy of more than $11,000 for a consumer who takes a prescription medication regularly. The total was nearly three-quarters of the average Social Security retirement benefit of $15,526, almost half the median income of a person on Medicare, and nearly one-fifth of the median U.S. household income.
Most Common Prescriptions and Average Cost by State
SearchRx compiled a list of the average costs of prescription drugs by state. At an average price of $12.82 per prescription, Mississippi tops the list as the US state with the lowest average per prescription cost. Arkansas was also low at $12.93, followed by Virginia at $13.90 and Louisiana at $13.10. Hawaii was the most expensive state to fill a prescription, at an average of $19.47, followed by North Dakota at $19.07, Alaska at $18.96 per prescription, and Delaware at $18.51.

The website also lists the most commonly prescribed medications last year:
1. Atorvastatin Calcium (generic for Lipitor) – lowers cholesterol and reduces risk of heart attack, stroke, and other complications in patients with type 2 diabetes, coronary heart disease, or other risk factors
2. Levothyroxine (generic for Synthroid) – primary use is for the treatment of hypothyroidism but it is also used to treat or prevent goiter
3. Lisinopril (generic for Prinivil) – for hypertension or congestive heart failure
4. Omeprazole (generic for Prilosec) – treats symptoms of GERD
5. Metformin (generic for Glucophage) – improves blood sugar in patients with type 2 diabetes
6. Amlodipine (generic for Norvasc) – for hypertension or anginafrank-magliochetti-report-drug-pricing
7. Simvastatin (generic for Zocor) – lowers cholesterol and triglycerides
8. Hydrocodone/Acetaminophen (generic for Lortab) – relieves moderate to moderately severe pain
9. Metoprolol ER (generic for Toprol XL) – treats angina and hypertension
10. Losartan (generic for Cozaar) – treats hypertension and reduces the risk of stroke in those with heart disease
SearchRx also ranked pharmacy chains in order of least expensive to most expensive. Walmart was the least expensive, followed by Target, “other,” Rite Aid, and CVS. Walgreens was the most expensive on the list.
If current trends continue, 2017 will see higher prescription prices, increased health premiums, and continued increases in the number of Americans who take prescription drugs every day.
Source
http://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm

https://www.washingtonpost.com/news/to-your-health/wp/2016/01/11/prescription-drug-prices-jumped-more-than-10-percent-in-2015/

http://time.com/money/4406167/prescription-drug-prices-increase-why/

https://aspe.hhs.gov/pdf-report/observations-trends-prescription-drug-spending

http://www.wsj.com/articles/for-prescription-drug-makers-price-increases-drive-revenue-1444096750

http://www.aarp.org/content/dam/aarp/ppi/2016-02/RX-Price-Watch-Trends-in-Retail-Prices-Prescription-Drugs-Widely-Used-by-Older-Americans.pdf

https://www.searchrx.com/blog/2016-prescription-prices-and-purchase-trends/

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Augmented Reality: A Disruptive Trend that is Changing Healthcare

Augmented Reality: A Disruptive Trend that is Changing Healthcare

Google Glass and other types of augmented reality (AR) never really took hold in the consumer market but the advanced technology is now poised to be a disruptive trend that will forever change healthcare for patients and providers.frankmagliochettireport_medicalaugmentedreality
A Q4 2016 report by ABI Research suggests augmented reality will gain momentum as medical professionals seek out new tools and technologies to improve care and outcome for their patients. The research firm suggests regulatory activity will push the medical profession towards AR.

About Augmented Reality in Medicine

Augmented reality is a live view of a real-world environment supplemented with computer-generated sounds, graphics or other sensory input. Unlike virtual reality, which entirely replaces the real world with a simulated one, augmented reality replaces only certain elements.
AR can include “see what I see” applications, education and training. “See what I see” apps can transmit what EMTs see to emergency department physicians. In medical applications, augmented reality applications can simulate how it would feel to have certain medical conditions.
frankmagliochetti_augmentedrealityinmedicineAR applications (apps) can help patients check visual symptoms against a medical database or share information in real time with their doctors. Patients with hearing problems can use AR apps and their smart phones to convert auditory information, such as the screech of brakes or a loudspeaker announcement on an airplane, into text displayed on the smart phone. AR apps can highlight maps of wheelchair-friendly routes when an individual visits a city for the first time.
Augmented reality can provide medical training to a large number of students, even those living in remote or impoverished areas. Students use AR to practice surgical techniques, or even allow experienced surgeons to practice procedures on a three-dimensional AR rending of a patient before performing the procedure on the actual patient.

Augmented Reality Applications are Already in Use

Eye Decide by OrcaMD is an educational application that could potential improve patient compliance. This education tool simplifies complex eye conditions and treatments in a way that improves knowledge, understanding and retention. Users can view the eyeball from any angle, with and without skin. Eye Decide also demonstrates the effects of cataracts, age-related macular degeneration (AMD), and other eye conditions, so that patients can see what a particular disease will eventually do to their vision without proper treatment.
AccuVein displays a map of a patient’s vein to make placing needles easier and more accurate. The healthcare practitioner uses a handheld scanner that detects heat radiating from the veins, converts information gathered about that heat into a map of the veins, and then projects this map onto the patient’s skin. AccuVein enjoys a 40 percent annual growth rate. By the middle of 2015, this augmented reality app had already helped more frankmagliochetti_report-augment-reality-healthcarethan 10 million patients. Sales will likely continue at a robust pace as patients and nurses demand the technology to reduce the average number of “sticks” involved in placing an intravenous (IV) needle.
Many legally blind people still have some vision but cannot see well enough to recognize faces, drive, read, or avoid obstacles in their path. VA-ST is a visor that combines a 3D camera with a computer to enhance vision by improving contrast, and highlighting edges and features. Users can even pause or zoom video for a clearer view. This technology will become more popular as the population of the United States ages and suffers age-related vision loss.
Like other industries, medicine leverages new technology to improve efficiencies and performance. The move from a per-service reimbursement structure towards one that focuses on quality of care will spur growth of augmented reality in medical settings.

Source
https://www.abiresearch.com/market-research/product/1025909-ar-in-telemedicine-training-and-first-resp/
https://itunes.apple.com/us/app/eye-decide-education-engagement/id454280553?mt=8
https://orcahealth.com/
http://www.accuvein.com/inf/
http://www.accuvein.com/2015/06/vein-visualization-emerges-as-premier-augmented-reality-application/
http://www.va-st.com/smart-specs/

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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2017 Trends in Cancer Care Drugs

2017 Trends in Cancer Care Drugs

Frank Magliochetti Report

Cancer drug development will continue to be a key focus area in 2017. While the number of new cancer frank-magliochettireport_2017_cancer-stopcases in the United States each year remains constant at about 1.7 million, the American Cancer Society says that the cancer death rate has plummeted 23 percent since the early 1990s. This is largely due to improved diagnostics, early detection, and new medications and treatments.
There has been extensive development of cancer medications in the past decade, and the development of oncology drugs will continue to be a key focus area in 2017. There are several important factors affecting cancer drug development in the upcoming year, including a large number of clinical trials already underway, the possibility of shortened regulatory approval time, and increases to consumer cost.

Cancer Drug Development

Extensive development of cancer medications is already underway, and much of this development will continue into 2017. New medicines, just launched within the past five years, now treat more than 20 types of tumors, according to a new report from IMS Institute for Healthcare Informatics. In fact, there were 70 new oncology treatments for more than 20 uses launched from 2011 to 2015. Further research of these new agents will likely result in approval for subsequent indications and provide therapeutic options to more patients.2017_cancertrends_frankmagliochetti
While there is substantial opportunity in the cancer drug industry, there will also be stiff competition in 2017. More than 500 companies are actively engaged in developing oncology drugs. Collectively, these companies are pursuing nearly 600 indications, primarily for non-small cell lung cancer, breast, prostate, ovarian and colorectal cancers.
This giant and diverse group of pharma companies has created a healthy pipeline of oncology drugs in clinical development. In fact, the pipeline of cancer drugs in clinical development has grown more than 60 percent over the past ten years.
Nearly 90 percent of these drugs are targeted agents, and the trend towards targeted agents will likely continue. There are more than 120 clinical development project underway for targeted agents to treat non-small cell lung cancer and melanoma, for example, and each features different mechanisms and combinations that promise new benefits.
It is taking less time for new cancer treatments to receive regulatory approval. The median time from patent filing to approval for cancer drugs in the U.S. dropped from 10.25 years in 2013 to 9.5 years in 2015. Initiatives such as the FDA Breakthrough Therapy designation expedite development and review of drugs that treat serious or life-threatening diseases or conditions.

Patient Costs may Rise

In campaign speeches, the new President-elect of the United States has promised changes to the Affordable Care Act, and these changes may increase patient costs. Average treatment costs for a year of cancer care for patients with commercial insurance plans rose 19 percent to $58,097 in 2014.  Cost increases in 2017 may depend on where the patient receives care. Outpatient services account for more than half of the total costs, according to the IMS report, and the average combined total cost of all  drugs used by the patient accounts for 28 percent of the total cost of care.
Average costs for administering cancer drugs are usually twice as high when patients receive treatment in hospital outpatient settings than when they receive care in physician offices. Higher costs for outpatient care increases patient cost responsibility. Coupons and other forms of assistance may offset the cost to consumers.

Source

http://onlinelibrary.wiley.com/doi/10.3322/caac.21332/abstract
https://morningconsult.com/wp-content/uploads/2016/06/IMS-Institute-Global-Oncology-Report-05.31.16.pdf

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Diabetes Trends: National and by State

Frank Magliochetti Report – Diabetes Trends

The rates of diabetes across the United States have nearly doubled within the past 20 years, skyrocketing from 5.5 percent in 1994 to 9.3 percent in 2014. While diabetes prevalence is increasing, there is some good news on the horizon in regards to complication rates and access to preventive care.
Of the 12 states with the highest rates of diabetes, 10 are in the south, according to the CDC’s Diabetes Report Card. At 14.7 percent, Mississippi has the highest rate of diabetes. Colorado and Utah have the lowest rates of this metabolic disorder, with diabetes affecting only 7 percent of Utah residents and 6.8 percent of those living in Colorado. frankmagliochetti_diabetestrends-reportDiabetes rates vary between 8.1 and 10.4 in the Northeast. New Hampshire has the lowest rates in the region while Pennsylvania has the highest prevalence in the Northeast.
While the prevalence of diabetes is increasing, there has been a downturn in the percentage of diabetes complications over the past two decades. Deaths from hyperglycemic crisis have declined, for example, as have lower-limb amputations and end-stage renal disease. These declines may be, at least in part, the result of improvements in the rates of hypertension, high cholesterol, and smoking. Advancements in blood glucose control, early detection and management of complications, and strides in preventive care, treatment and management of diabetes.

Preventive Care Usage Trends: Across the Nation and by State

Preventive care varies considerably between states.

The percentage of adults with diabetes who report receiving preventive care practices across the nation is as follows:
• Annual foot exam: 67.5 percentfrankmagliochettireport-diabetes
• Annual eye exam: 62.8 percent
• Checked A1c two or more times a year: 68.5 percent
• Daily self-monitoring of blood glucose: 63.6 percent
• Ever attended a diabetes self-management class: 57.4 percent
• Flu vaccine: 50.1 percent
Preventive care usage varies by state. At 85.8 percent, adults with diabetes in Maine report receiving the highest number of annual foot exams as compared with all other states, while residents of Nevada received the fewest. Adults with diabetes in New Hampshire and Vermont also received more annual food exams than the national average.
Adults with diabetes in Iowa received more eye exams than those in other states at 76.5 percent, while those in Oklahoma received the least number of eye exams. Vermont diabetics were more likely to check their A1c levels more than twice a year, affordablecareact_frankmagliochettireportwhile those in Nevada were the least to receive such preventative care. Diabetes patients in Colorado had the highest percentage of attendance rates in diabetes self-management classes, while those in New York had the lowest. People with diabetes in Minnesota had the highest flu vaccination rates, and those in Florida had the lowest.
The upturn is due, at least partially, to the Affordable Care Act because it supports diabetes prevention and control by expanding insurance coverage, access to care, and consumer protections. As the result, Medicare and other insurance providers now cover an increasing number screening tests for diabetes, pre-diabetes, and for complications associated with diabetes. Providers also offer an expanding list of preventive benefits that help support beneficiaries in self-care and in making lifestyle changes that prevent or minimize development of comorbidities and complications associated with diabetes. The expansion of coverage and preventive care will continue to affect diabetes trends across the nation and within each state.

Source:
http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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2017 – Year of Equilibrium for Medical Costs  

Medical Costs

Frank Magliochetti Report

PwC calls 2017 the “year of equilibrium for medical costs” in its recent publication, Medical Cost Trend: Behind the Numbers 2017. Authors of the PwC report expect growth rate for 2017 to remain unchanged at apricewaterhousecoopers_frankmagliochettireport 6.5 percent.

There are two main components of healthcare costs:

  • Unit price of services
  • Utilization, which is the volume and intensity of use of those services

Identifying trends in both unit price and utilization elucidates changes in overall spending. In other words, trends in unit prices and utilization provide a clear picture of whether costs are rising or falling, or if consumers are using more or fewer specific services and products.

Price, rather than utilization, had historically been the primary force behind medical cost trends. In the early 2000s, utilization grew to become on par with price as a major contributor to healthcare trend growth. Retail clinics and urgent care centers have made it more convenient for consumers to receive healthcare, and this convenience led to higher utilization. Greater utilization often results in reduced spending later down the road, especially if consumers use these clinics for preventive screening and for treatment of minor conditions before they become serious problems, but these savings may not reduce the short-term costs of higher utilization.

Recently, however, the price trend grew while the utilization trend declined. This decline in utilization shifts the focus back on the price trend, and does it in a frankmagliochettireport-health_costs-trends-2017way that may affect utilization.

Trends in 2017

PwC predicts mainstream attention and regulatory recognition will cause behavioral health, once largely ignored as a necessary health treatment, to become a crucial part of employer health benefits. The organization also expects slower cost growth among specialty drugs for the first time in several years.

PwC expects employers to consider new benefit strategies, especially those that focus on leveraging high-performing networks with lower costs and higher quality.

At 30 percent from hospital inpatient and 19 percent from hospital outpatient, about half of employer health costs currently come from hospital spending, but costs for prescription drug care will probably see modest cost increases in 2017. Political pressure will likely suppress some of the largest drug cost increases. Furthermore, PwC predicts pharmacy benefit managers will adopt new and more aggressive strategies, which will likely contribute to deflation in the medical cost trend.

What the Trends Mean for Businesses

Always looking for new ways to reduce costs, employers will likely focus less on cost sharing and more on sharing new provider networks. They may realign cost sharing for ambulatory services, for example, evaluate current arrangements made by pharmacy benefit managers, or explore high-performance networkmedicalcoststrends_frankmagliochettireport arrangements.

Faced with competition from new sites of care, healthcare providers who want to grow their market share may consider consolidations or affiliations with other health systems. They may create new partnerships with insurers, provide a more convenient healthcare experience to consumers, or collaborate with pharmacy benefits managers.

Insurers may find it challenging to keep premiums low and control costs in 2017. Transforming business models and encouraging patients to visit lower-cost, high quality providers may help.

In all PwC predicts medical costs will continue to rise in 2017 at the same rate as they did in 2016. The authors of the study predict larger increases in the future.

Source

http://www.pwc.com/us/en/health-industries/health-research-institute/behind-the-numbers.html

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Trends in Lyme Disease: Focus on the Northeast

Lyme Disease Trends: Northeast

cdc-frankmagliochettireportState health departments report about 30,000 cases of Lyme disease each year, according to the Centers for Disease Control and Prevention (CDC), but that number does not accurately reflect the actual number of cases diagnosed around the United States. Some studies suggest the actual number of Lyme disease could be as high as 444,000.

About Lyme Disease and its Transmission

Lyme disease is a vector-borne disease, which means a carrier moves from one host to another. This carrier, known as a vector, transmits the illness but the vector does not become infected with the disease.

The deer tick is the vector for Borrelia burgdorferi, the bacterium responsible for Lyme disease. Transmission occurs when a tick carrying the Borrelia burgdorferi bites a human to feed on the individual’s blood. The bacterium moves from the intestines of the tick through its mouthparts and into the human’s bloodstream while the tick feeds.

While a number of mammals carry Borrelia burgdorferi bacterium in their blood, the most common source of infection is the white-footed mouse.frankmagliochettireport-lyme-disease

Deer ticks are most likely to transmit the bacteria after remaining attached and feeding for two or more days. Ticks are most active from April to October in most areas but may bite year-round in milder climates.

Infection occurs quickly. Research shows traces of Borrelia burgdorferi can appear in the nervous system only 12 hours after infection. Lyme disease causes a rash, usually in a bull’s-eye pattern, and flu-like symptoms. Joint pain, headaches, and weakness in the limbs can also occur.

Doctors typically treat Lyme disease with antibiotics. Patients usually enjoy a full recovery, although some patients experience symptoms that linger for six months or longer, a condition known as Post-Treatment Lyme Disease Syndrome (PTLDS) or chronic Lyme disease. Pain medicine can help those with PTLDS overcome lingering symptoms.

frank-magliochetti-report-symptoms-of-lyme-disease

About Lyme Disease Trends

Lyme disease can affect people of any age or either gender, but it is most common in boys aged 5 to 9 years.

First discovered in Lyme, Connecticut, the disease is still most common in the Midwest and, especially, in Northeastern states. In fact, 14 states account for more than 96 percent of Lyme disease cases reported to the CDC.

The U.S. Environmental Protection Agency (EPA) developed maps that, based on the number of new cases per 100,000 people, illustrate how Lyme disease reports have changed since 1991. Trending statistics include national reports and reports from the 14 states where Lyme disease is most common.

The highest human risk for Lyme disease lies in the Northeast, Mid-Atlantic and Upper Midwest.

Nationally, there were 3.74 cases of Lyme disease per 100,000 people in 1991 and 7.95 per 100,000 in 2014. The number of cases reached their highest levels in 2013, when there were 8.59 reported cases of the disease per 100,000 people.

New Hampshire, Maine, and Vermont showed the greatest increase in reported cases of Lyme disease at 93.31, 84.13, and 83.02 cases per 100,000, respectively. Extreme year-to-year variations in reporting practices prevented the EPA from calculating trend activity in Connecticut, New York, and Rhode Island.

For more information on Lyme disease, consult with your doctor or another healthcare professional.

Source

http://www.cdc.gov/lyme/stats/humancases.html

http://www.caryinstitute.org/science-program/research-projects/lyme-disease

https://www.epa.gov/climate-indicators/climate-change-indicators-lyme-disease

https://www.epa.gov/sites/production/files/2016-08/lyme_fig-2.csv

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

frankmagliochetti_ParcaeCapital

Fentanyl-Related Overdoses Sweeping the Northeast

Fentanyl-related Overdoses Sweeping the Northeast

Fentanyl, which killed music legend Prince, killed more people in Virginia in 2015 than any other prescription painkiller. Legally purchased fentanyl rose only 10 percent from 2007 to 2014, yet annual death rates nearly tripled in that time, rising from 48 to 134 opiodcrisis_frankmagliochettireportdeaths each year. Fentanyl was responsible for 221 deaths in Virginia, more than any other opioid except for heroin.

The problem extends well beyond the borders of Virginia. On August 15, 2016, 26 people overdosed in less than four hours in Huntington, W. VA., a small city of just 50,000 that usually sees only two or three overdoses in a day. Pending toxicology results, officials there suspect heroin laced with fentanyl.

More than 80 percent of fentanyl seizures in 2014 occurred in 10 states, according to the National Drug Early Warning System(NDEWS), with most being in the eastern United States. These states are:

  • Ohio
  • Massachusetts
  • Pennsylvania
  • Maryland
  • New Jersey
  • Kentucky
  • Virginia
  • Florida
  • New Hampshire
  • Indiana

About Fentanyl

Fentanyl is an opioid, so it has the same physiological and psychological effects as morphine, codeine and heroin. It works by causing neurological changes that relieve pain and cause a pleasant euphoria.

It is a synthetic opioid, which means fentanyl has the same chemical structure as opium and other opiates made from the poppy plant but chemists create fentanyl in a laboratory instead of extracting it from the plant. Synthesizing opioids allows the chemists to drugs that are much stronger than are their natural counterparts.fentanyl_frankmagliochetti

Doctors prescribe fentanyl to treat chronic pain. Pharmaceutical fentanyl is available a variety of forms, such as patches, lozenges, tablets and film. Illicitly produced, non-pharmaceutical fentanyl is available in powder form, which the user can snort or inject, or in pill form.

A growing number of individuals are using fentanyl for its intense, albeit short-term high and temporary feelings of euphoria. It has become a black-market drug rivaling heroin; this is especially true now that Mexican and South American cartels started making the drug in underground labs.

People who use heroin may now unwittingly buy fentanyl or heroin mixed with fentanyl, which means they are consuming considerably stronger drugs than they realize. Even small amounts of fentanyl can be lethal, so using it as heroin or mixing it with heroin can cause a quick overdose.

Carfentanil – A New, More Potent Type of Fentanyl

Designer drugs, also known as analogs, mimic the pharmacological effects of the drug. Fentanyl has many analogs, including carfentanil (also spelled carfentanyl), one of the most potent opioids ever created. At about 100 times stronger than fentanyl and 10,000 times stronger than morphine, carfentanil is a potent elephant tranquilizer – it takes only 2 milligrams to knock out a 2,000-pound elephant – and it is now showing up in heroin.

Officials in Hamilton County, OH., issued a public health statement in July 2016 after 25 people in Akron overdosed in a 3-day period carfentanil-frankmagliochettireportand nine people in Columbus overdosed in a 9-hour window; four people died from those overdoses in Akron and two more died in Columbus. Officials have recently discovered carfentanil in local supplies of heroin there. “This discovery is ominous for those with the disease of addiction, as well as for first responders, hospital teams, law enforcement and those striving to reverse overdoses,” said Hamilton County Health Commissioner, Tim Ingram. “We issued a public health alert this morning to emergency departments and nurses, first responders and clinical staff working with substance abusers and it is crucial that we get this message out to everyone who is in contact with heroin users in our area.”

 

Source:

http://www.dailyprogress.com/townnews/pharmacology/fentanyl-is-now-state-s-deadliest-painkiller/article_5e102133-dc87-5b42-994c-59b055d0d4fe.html

https://ndews.umd.edu/sites/ndews.umd.edu/files/NDEWSSpecialReportFentanyl12072015.pdf

https://pubchem.ncbi.nlm.nih.gov/compound/carfentanil

http://www.elephantcare.org/Drugs/carfenta.htm

http://www.hamiltoncountyhealth.org/files/files/Press%20Releases/Carfentanil_7_15_2016.pdf

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

frankmagliochetti_ParcaeCapital

 

Handheld Medicine

Handheld Medicine: Doctors Connecting with Patients using Smartphones

Frank Magliochetti Report

Doctors are connecting with patients in an entirely new way – through smartphones.Mobile payments, apps, and digital advertising changed the way retailers work by providing new opportunities to attract new customers, build loyalty and improve sales. Now these same technologies that altered retail are revolutionizing the world of medicine. The use of smartphones and apps helps drive down costs, increases access to information, and fulfills the public’s desire for “anytime, anywhere” diagnosis, treatment and monitoring.

frankmagliochetti_doctormobilevideocallUntil now, the healthcare industry has underutilized smartphones, apps and even connected medical accessories. This is changing, as connectivity allows consumers to take control of their own care. The adoption of mobile health apps has doubled in only two years. The percentage of consumers with at least one medical, health or fitness app increased from 16 percent in 2013 to 32 percent in 2015, according to PWC.

Primary care practitioners and chronic disease managers are leading the way towards a new generation of telemedicine, and patients are eager to follow. Doctors in India set up patients with smart home monitoring kits that connect wireless to the company’s online platform. From there, patients can connect with a wide range of specialists, including dermatologists, cardiologists and fertility doctors who can conduct virtual examinations and prescribe medicine from remote locations.

Clinicians in the United States can now use their smartphones as digital otoscopes. A growing number of clinicians now send patients with chronic conditions home with connected pacemakers, glucose trackers, ECG monitors and other types of remote monitoring devices. Patients can turn their phones into precision digital scales for weighing out food or connect their bathroom scales to mobile app on their phones to track their weight. Symptom checkers, activity trackers, and on-demand e-visits are now available directly to consumers.

The Future of Smartphone Medicine

Moving towards mobile care will cause a dramatic shift in the needs of the healthcare community. Organizations will need assistance managing utilization, connecting healthcare providers working in remote locations, and overseeing the massive amount of data transferred and stored. There will be an increasing need to evaluate the security, privacy and risk associated with using these new tools.frankmagliochetti-report

Connected tools will create fresh links between healthcare and industries with which it rarely interacts, such as retail, hospitality and financial services. Connectivity will also generate more opportunities for healthcare providers and patients to plug in.

Healthcare providers can look forward to engaging in virtual medicine as more facilities build that technology into their long-term strategic plans. Virtual medicine allows health systems to move away from centralized brick-and-mortar locations towards decentralized partnerships and joint ventures to create “bedless” hospitals. Even with the limited smartphone medicine in use today, a growing share of clinicians can already deliver care remotely.

Patients are Eager to Participate

About 68 percent of adults in the United States have smartphones, according to Pew Research Center, which is up from just 35 percent in 2011. Tablet ownership is up to 45 percent.

aha_frankmagliochettiConsumer interest in telemedicine is growing as quickly as interest in smartphones. According to survey results provided by the American Hospital Association, 74 percent of U.S. consumers would be willing to use telehealth services and 30 percent already use computers or mobile devices to check for medical information. Seventy percent are comfortable communicating with their doctors via email, text or video rather than seeing them in person. More than three out of four patients believe that access to care is more important than human interaction with their healthcare providers.

Advanced hardware technology, the introduction of new apps and wireless links facilitates the move towards handheld medicine.

Sources:

http://www.pwc.com/us/en/health-industries/top-health-industry-issues/care-in-palm-of-hand.html

https://www.doctorkepaas.com/

http://www.medicalpracticeinsider.com/news/oto-converting-iphone-digital-otoscope

https://play.google.com/store/apps/details?id=rascsoft.precisionbalance&hl=en

http://weightgurus.com/http://www.pewinternet.org/2015/10/29/technology-device-ownership-2015/

http://www.aha.org/research/reports/tw/15jan-tw-telehealth.pdf

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

frankmagliochetti_ParcaeCapital